Eye-Hand Coordination Skills in Children with and without Amblyopia

Dr. Tannen’s Research Review:

 In this important research article published in Investigative Ophthalmology and Visual Science in March 2011, it is shown that children with amblyopia have significantly poorer “reach” and “grasp” skills compared to normally sighted children at all ages tested.  The acquisition of precise eye-hand coordination for reaching, grasping, and manipulating objects is essential to many of our everyday activities.  It is seen as an important prerequisite for development of perceptual skills that are essential for action planning in hand movement and visual guidance.   It is postulated that the lack of stereopsis in amblyopic children is at the root cause of the eye-hand coordination deficits and that restoring binocularity in children with amblyopia may improve their poor eye-hand action control.


Purpose: To investigate whether binocular information provides benefits for programming and guidance of reach-to-grasp movements in normal children and whether these eye-hand coordination skills are impaired in children with amblyopia and abnormal binocularity.

Methods: Reach-to-grasp performance of the preferred hand under binocular versus monocular (dominant or non-dominant eye occluded) conditions to different objects (2 sizes, 3 locations, 2-3 repetitions) was quantified using a 3D motion-capture system. Participants were 36 normally-sighted children (aged 5-11) and 11 adults, and 21 children (aged 4-8) with strabismus and/or anisometropia. Movement kinematics and error rates were compared for each viewing condition within- and between-subject groups.

Results: The youngest control subjects employed a mainly programmed (ballistic) strategy and collided with the objects more often when viewing with only one eye, while older children progressively incorporated visual feedback to guide their reach and, eventually, their grasp, resulting in binocular advantages for both movement components resembling those of adult performance. Amblyopic children were the worst performers under all viewing conditions, even for the dominant eye. They spent almost twice as long in the final approach to the objects and made many (1.5-3 times) more errors in reach direction and grip positioning as their normal counterparts, these impairments being most marked in those with the poorest binocularity, regardless of the severity or cause of their amblyopia.

Conclusions: The importance of binocular vision for eye-hand coordination normally increases with age and use of ‘on-line’ movement guidance. Restoring binocularity in children with amblyopia may improve their poor hand action control.


  1. Catherine M Suttle 2,
  2. Dean R Melmoth 1,
  3. Alison L Finlay 1,
  4. John J Sloper 3 and
  5. Simon Grant 1

+ Author Affiliations

  1. 1Department of Optometry & Visual Science, The Henry Wellcome Laboratories for Visual Sciences, City University, Northampton Square, London EC1V 0HB, UK.
  2. 2 School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2052, Australia.
  3. 3 Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK.

7 thoughts on “Eye-Hand Coordination Skills in Children with and without Amblyopia

  1. Am I missing something here. Someone did a study proving that amblyopia interferes with eye hand coordination? Well congratulations to the successful outcome of the study. At least they made a sensible conclusion.

    Now maybe they will get some answers in regard to other binocular skills effecting reading rather than blanketly accepting on one concluded outcome which tends to be convergence insufficiency. They are off to a good start.

    • You’re right Dan. Lots of research ends up just proving the obvious. A good example is the 2002 The Early Manifest Glaucoma Trial which “proved” that reducing IOP delays visual field loss and optic nerve head changes in early open angle glaucoma patients. Good thing we weren’t getting that one wrong!

  2. Pingback: New Scientific Evidence for Amblyopia Treatment…Two Eyes are Better than One! « The VisionHelp Blog

  3. Hello. My name is Mark and I have amblyopia. My condition wasn’t caught until a first grade eye examination. My right eye was farsighted. My mother always noticed I was bumping into things as a young child. My father worked with me from an early age with throwing and catching a baseball. My left eye is dominate and I am right handed. I was able to play sports with no problem. Apparently, I had enough depth perception to caught and hit a baseball. Also played basketball and football. So, even with a lazy eye, you still can have depth perception and peripheral vision.

    • Hi Mark,
      Your comments raise some good points. Just because you had amblyopia, it doesn’t mean you do not (or did not) have any binocular depth perception as a child. Also, just by wearing the appropriate spectacles, your depth perception may have improved (and definitely the case with peripheral vision) and even more so if you had amblyopia therapy. Finally, practice and muscle memory with regards to sports, perhaps trump even depth perception in importance. Thanks for sharing.

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